Critical Consciousness, Racial and Gender Discrimination, and HIV Disease Markers in African American Women with HIV

Kelso, Gwendolyn A.; Cohen, Mardge H.; Weber, Kathleen M.; Dale, Sannisha K.; Cruise, Ruth C.; Brody, Leslie R.

doi:10.1007/s10461-013-0621-y

Cited by 66 publications

(54 citation statements)

References 56 publications

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“…Researchers have postulated that impoverished African American women live in a society where they experience discrimination and marginalization based on their group membership such as gender, race, poverty, drug use or incarceration history (Amaro, 1995; Keslo, 2014; Windgood & DiClemente, 2000). Social welfare and criminal justice policies have historically disproportionately criminalized their substance use, imposed harsher drug sentences (Burke, 2002; Roberts, 1997) and promoted self-shaming and stigmatization (Harris-Perry, 2011; Wingood & Diclemente, 2000).…”

Section: Discussionmentioning

confidence: 99%

Intra-group stigma: Examining peer relationships among women in recovery for addictions

Gunn

Canada

2015

Drugs: Education, Prevention and Policy

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This grounded theory study explores how women with histories of addiction perceive stigma while in treatment. In-depth interviews were conducted with 30 women participating in a residential drug treatment center. Previous research has found that support from peers during recovery can be critical to managing illnesses. In fact, researchers have postulated that peers can be a more effective form of support than even family. This study extends existing literature indicating that peer support systems can be supportive, however they can also can be perceived as negative support that impose stigmas. Findings reveal that women perceive stigmas due to how various types of drug use violate societal expectations and conflict with notions of deservingness. Specifically, the “hard users” (i.e., women who use heroin or crack cocaine) perceive stigmas regarding how their drug use violates norms of womanhood. Moreover, the “soft users” (i.e., those who use alcohol or marijuana) perceive stigmas that their drug use is considered undeserving of support. This paper explores the factors that contribute to stigma amongst populations who potentially face marginalization from larger society. Implications for treatment and group work are discussed.

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Section: Discussionmentioning

confidence: 99%

Intra-group stigma: Examining peer relationships among women in recovery for addictions

Gunn

Canada

2015

Drugs: Education, Prevention and Policy

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“…This measure has been shown to be a valid measure of adherence. 42,43 As in previous studies, 29,44 we used the cutoff for optimal versus sub-optimal adherence to be at 95%, resulting in a dichotomized variable.…”

Section: Methodsmentioning

confidence: 99%

Association between Perceived Discrimination in Healthcare Settings and HIV Medication Adherence: Mediating Psychosocial Mechanisms

et al. 2017

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There is insufficient research on the impact of perceived discrimination in healthcare settings on adherence to antiretroviral therapy (ART), particularly among women living with HIV, and even less is known about psychosocial mechanisms that may mediate this association. Cross-sectional analyses were conducted in a sample of 1356 diverse women living with HIV enrolled in the Women’s Interagency HIV Study (WIHS), a multi-center cohort study. Indirect effects analysis with bootstrapping was used to examine the potential mediating roles of internalized stigma and depressive symptoms in the association between perceived discrimination in healthcare settings and ART adherence. Perceived discrimination in healthcare settings was negatively associated with optimal (95% or better) ART adherence (adjusted odds ratio AOR = 0.81, p = .02, 95% confidence interval CI [0.68,0.97]). Furthermore, internalization of stigma and depressive symptoms mediated the perceived discrimination-adherence association: Serial mediation analyses revealed a significant indirect effect of perceived discrimination in healthcare settings on ART adherence, first through internalized HIV stigma, and then through depressive symptoms (B = −0.08, SE = 0.02, 95% CI [−0.12, −0.04]). Perceiving discrimination in healthcare settings may contribute to internalization of HIV-related stigma, which in turn may lead to depressive symptoms, with downstream adverse effects on ART adherence among women. These findings can guide the design of interventions to reduce discrimination in healthcare settings, as well as interventions targeting psychosocial mechanisms that may impact the ability of women living with HIV to adhere to ART regimens.

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“…In addition, the majority of women diagnosed with HIV in the U.S. are African American and they experience racism (Kelso et al, 2013). Moreover, the HIV diagnosis itself constitutes an adversity since it is a chronic illness that needs to be closely monitored and is associated with stigma on multiple levels, affecting work, family, friends, and sexual relationships (Demarco, Lynch, & Board, 2002; Golub, Tomassilli, & Parsons, 2008; Whetten, Reif, Whetten, & Murphy-McMillan, 2008).…”

Section: Introductionmentioning

confidence: 99%

Resilience Among Women with HIV: Impact of Silencing the Self and Socioeconomic Factors

et al. 2014

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In the U.S., women account for over a quarter of the approximately 50,000 annual new HIV diagnoses and face intersecting and ubiquitous adversities including gender inequities, sexism, poverty, violence, and limited access to quality education and employment. Women are also subjected to prescribed gender roles such as silencing their needs in interpersonal relationships, which may lessen their ability to be resilient and function adaptively following adversity. Previous studies have often highlighted the struggles encountered by women with HIV without focusing on their strengths. The present cross-sectional study investigated the relationships of silencing the self and socioeconomic factors (education, employment, and income) with resilience in a sample of women with HIV. The sample consisted of 85 women with HIV, diverse ethnic/racial groups, aged 24 – 65 enrolled at the Chicago site of the Women’s Interagency HIV Study in the midwestern region of the United States. Measures included the Connor-Davidson Resilience Scale -10 item and the Silencing the Self Scale (STSS). Participants showed high levels of resilience. Women with lower scores on the STSS (lower self-silencing) reported significantly higher resilience compared to women with higher STSS scores. Although employment significantly related to higher resilience, silencing the self tended to predict resilience over and above the contributions of employment, income, and education. Results suggest that intervention and prevention efforts aimed at decreasing silencing the self and increasing employment opportunities may improve resilience.

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Critical Consciousness, Racial and Gender Discrimination, and HIV Disease Markers in African American Women with HIV

Cited by 66 publications

References 56 publications

Intra-group stigma: Examining peer relationships among women in recovery for addictions

Intra-group stigma: Examining peer relationships among women in recovery for addictions

Association between Perceived Discrimination in Healthcare Settings and HIV Medication Adherence: Mediating Psychosocial Mechanisms

Resilience Among Women with HIV: Impact of Silencing the Self and Socioeconomic Factors

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